MEDICARE: EZ CHIROPRACTIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12455	TX
2	111NN1001X	Nutrition Chiropractor	12455	TX
3	111NR0400X	Rehabilitation Chiropractor	12455	TX
4	111NS0005X	Sports Physician Chiropractor	12455	TX
5	111NN0400X	Neurology Chiropractor	12455	TX

General Provider Information

NPI Number	:	1124456686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZ CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	1809 FRANKLIN ST
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75060-5921
Country	:	US
Telephone Number	:	214-600-4092
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 LAS COLINAS BLVD W STE 1650
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-5436
Country	:	US
Telephone Number	:	817-821-0004
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARNALDO ANTONIO LOPEZ JR.
Credential	:	D.C.
Telephone Number	:	817-821-0004

Provider Enumeration Date	:	10/21/2013
Last Update Date	:	10/21/2013

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Directions to “EZ CHIROPRACTIC PC ” Practice Location

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